Empirical antibiotics are usually
prescribed for UTIs. The patient may be
prescribed alternative antibiotics after
the urine culture results are available.
The duration of treatment of the UTI
depends on the antibiotic in use. Some
common first-choice agents for the
treatment of uncomplicated cystitis in
women include nitrofuratoin, bactrim
or beta-lactams such as cephalexins.
Most patients can be treated on an
outpatient basis. However, hospital
admission for management of
complicated UTIs may be indicated
in some patients. Complicating
factors include the presence of
structural abnormalities (e.g. stones,
indwelling catheters), metabolic
disease (e.g. diabetes, pre-existing
kidney disease) or patients who are
immunosuppressed and therefore
more prone to serious infections (e.g.
HIV, patients on chemotherapy).
Recurrent UTI is defined as having
UTI three or more times in a year.
This can be due to the same or
different bacteria. In these cases,
further investigations may need
to be done, e.g. renal ultrasound,
intravenous pyelogram, cystoscopy,
urine for tuberculosis and cytology,
to look for any underlying causes and
complications of recurrent UTIs.
Patients with recurrent UTI may be
given prophylactic antibiotics for a
period of six months. They will also
be advised on the various preventive
measures and the importance of
keeping good personal hygiene.
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